Abstract

The prevalence of overweight and obesity is increasing worldwide at an alarming rate and the Kingdom of Saudi Arabia at increased risk of a multitude of obesity-associated problems. There are multiple causal factors associated with childhood obesity, but the modifiable ones are dietary and activity behaviours. In order to accomplish this, it is vital to assess and evaluate whether an intervention to promote healthy lifestyle behaviours in school-age girls is effective in reducing their Body Mass Index (BMI). To measure the effect of such an intervention requires a large sample across a wide geographical mass and therefore a feasibility study is necessary before conducting a study of this size, to explore the most effective form of the intervention and methods for measuring its effectiveness. Although several obesity-related intervention studies were published worldwide, the current feasibility study was conducted for the first time in Madinah, Saudi Arabia. Therefore, this feasibility study was conducted to determine the viability of promoting healthy eating and physical activity with school girls (aged 9 to 16 years) in Saudi Arabia, in order to prevent childhood obesity.

Saudi schoolgirls were included in the current feasibility study, using both quantitative and qualitative methods. A sequential explanatory design was adopted, allowing sequential implementation of quantitative and qualitative components. Parent questionnaires (n=90) on children’s nutrition and physical activity habits were issued pre-intervention. A children’s self-report questionnaire (n=90) and anthropometric measures were conducted pre- and post-intervention to assess the impact of the education programme. Semi-structured interviews (n=18) were conducted to explain the results from the questionnaires. The intervention aims to promote healthy eating and physical activity in Saudi School children, based on the constructs of the Social Cognitive Theory. The intervention consisted of two components: a presentation and interactive sessions delivered in about 2 hour session at Taibah school.

In the pre-intervention study, the results showed cases of overweight (23.3%) and obesity (5.6%). Participants showed some levels of nutrition and physical activity awareness. A significant proportion of girls engaged in sedentary behaviours (using a smartphone/tablet (28.9%) for >3 hours). Participants consumed energy-dense foods (fast foods 83%, non-diet drinks 66.7%) 1–3 times per week. In addition, the results indicated that after-intervention the participants’ average number of hours of exercise was higher (M = 4.64) than the corresponding hours of exercise after intervention (M = 1.71), while sedentary activity reduced. Reported decrease in consumption of unhealthy foods while healthy foods increased. There were no significant differences between pre- and post-intervention weight (p=0.669) or BMI (p=0.856). BMI categories changed, indicating more normal weight and fewer overweight participants. Further, the qualitative data analysis indicated that participants had prominent level of sedentary activities, mainly playing video or watching television. These data, also, indicated culture impact on the choice of food and level of physical activity.

The school-based intervention was found to be a feasible intervention that motivates changes in lifestyle behaviours and BMI. Regular physical education and healthy eating classes, and increased access to healthy foods at school shops can help to combat obesity. This school based-intervention has shown potential to improve health lifestyle among Saudi girls and to prevent childhood obesity, which can make a positive impact on their health. However, further research is needed to confirm the impact of obesity education intervention programme with a larger sample over a longer time-period.